A study of morbidity and mortality of surgically managed hip fractures in elderly patients in the 1st Year

Abstract

Background: Fractures of hip are one of the most common injuries sustained by the elderly. They occur predominantly in patients aged over 60 years. For many, this fracture is often a terminal event resulting in death due to comorbidities and cardiac, pulmonary, or renal complications. The incidence of morbidity and mortality after hip fractures was evaluated in this study. Methodology: We included 102 patients who were divided into two groups; 54 patients with fracture neck treated by hemiarthroplasty as arthroplasty group, and 48 with intertrochanteric fracture treated by internal fixation with proximal femoral nail or with dynamic hip screw as internal fixation (IF) group were followed up for 1 year. The preexisting medical comorbidities, intraoperative findings, and postoperative complications were documented. The final functional results were evaluated using Merle d'Aubigne score at the end of 1 year. Results: This is a descriptive cohort study from the local population. The mean age was 74.5 years. We noted a total mortality of 17.6%. Diabetes mellitus and anemia were the most common comorbidities. Binary logistic regression analysis was performed to predict the survival status among the study patients. We found that male patients with anemia to be most associated with mortality. Excellent results were noted in 39% of cases of arthroplasty and 60% of cases of IF. Morbidity experienced was greater in extracapsular fracture type, who were less mobile during the postoperative period. Conclusion: Hip fractures are on a rising trend in the elderly population, especially in the Indian subcontinent. Mortality and morbidity in elderly patients in the 1st year are significant. Age and preexisting comorbidities contribute to morbidity. Morbidity leads to loss of independence and requirement of social support. The goal of treatment in fractures of the hip must be the restoration of the patient to their preinjury status at the earliest possible time.